CPAP Equipment: CPAP Masks: Nasal Pillow

Nasal Pillow CPAP Mask Overview

Nasal pillow CPAP masks seal around the base of the nostrils, also called nares, using a soft pillow. Nasal pillow systems are held in place by headgear. They do not seal over your mouth. This design is preferred by those who want a minimal amount of weight and material on their face. Some users find pillows irritating to their nares. This style of CPAP mask has consistently gained popularity since its introduction to the market.

Nasal Pillow FAQs

Nasal pillow delivery systems offer less contact with the face than either full face or traditional nasal masks. This system works well for those who tend to feel closed in or claustrophobic. Many nasal pillow systems have nothing that cross in front of the bridge of the nose allowing for a clear line of sight for reading or watching TV.

It can be easier to achieve a seal with this system, because there is less for you to adjust and less surface area to create and hold a seal.

Nasal pillow systems may work well for someone with a mustache or beard as the seal occurs only at the nares or nasal opening.

Someone who has a facial mole or scar near or around the nose, may find getting a seal with a traditional nasal mask difficult. Nasal pillows are an option in this circumstance.

Most nasal pillow masks also come with all sizes included to make finding the right size easier.

Sleeping on your side or stomach is preferable to sleeping on your back because sleeping on your back worsens all forms of sleep-disordered breathing. However, sleeping on your side or stomach can present problems with CPAP therapy. Both positions can put pressure on one side of your mask increasing your leak rate. Your options are to (1) try a mask that other side sleepers like (2) try bed pillows made for CPAP users.

Special CPAP Pillows: Regular bed pillows can put pressure against the mask and cause leaks. CPAP pillows are made with CPAP users in mind. These special pillows are designed to minimize the contact of the CPAP mask with the pillow, even when you are sleeping on your side.

Nasal pillow and nasal prong masks seal only at the nostrils or nares. Therefore, only the size of the nostrils has to be considered when selecting a delivery system. Also, most nasal pillows masks come with all sizes included to offer options for the user. Some nasal and full face masks are offered in smaller sizes.

We have created a selection filter so you can easily see the masks that we would recommend for people with small faces. View masks for small faces.

The answer to this question depends on the mask. In most cases, the mask frame will only accept cushions or pillows made for that specific mask. There are a few exceptions to this. For instance, there are two masks by ResMed the Mirage SoftGel Nasal CPAP Mask and the Mirage Activa LT Nasal CPAP Mask, in this case the cushions are interchangeable between the two masks. You can buy one of these masks and use the same sized cushion in the other model of mask on the same mask frame. The EasyFit line of masks by DeVilbiss offeres different cushion types which are interchangeable between the mask frames.

As to whether or not you can use different sized cushions for a specific mask on the same mask frame, this also depends on the mask. Some mask frames are compatible with multiple cushion or pillow sizes and other mask frames will fit only the cushion of the same size. This information is provided on the product pages. Please review the page of the specific product you are interested in to learn if you will need a different size mask frame for each size of cushion or pillow. For assistance, contact us at 1-800-356-5221.

We provide our customers with many tools to make informed decisions about their mask purchases. Options include:

Calling a CPAP Expert Toll Free. 1-800-356-5221.

Comparison Charts. These charts compare available masks, feature by feature. If you're unsure of the meaning of a feature, click on or hover over the question mark for a pop out definition. Click on the image or name of the product for more detailed product information, pictures and resources.

Help Me Choose Guide. We created a guide to help you select the right mask or machine according to your preferences. The guide asks you a series of questions regarding your preferences and your facial features. Based on your answers we provide you with a comparison chart of the masks that meet your criteria. Get started here:

Browse Our Mask Product Categories. These categories show each mask our company offers, ranked by popularity. Popularity is determined by a mix of sales data and our in-house opinion of the quality of the mask based on our experience and customer feedback. The best products float to the top of our categories.

Sizing Guides. Many Nasal and Full Face masks have sizing guides available to help determine the size needed. Simply print the sizing guide, cut out if needed, and use a mirror or helper to look at the guide to see if it is a proper fit on the face. Please note, to ensure the guide is the proper size, it should be printed in PDF format at 100% scale, meaning "Fit to Page" may have to be disabled.

Return Insurance. With every mask we sell, you have the option of purchasing Return Insurance. Masks are FDA approved medical devices. Once a mask is used, it cannot be resold to another customer. CPAP.com was the first in the industry to offer Return Insurance to our customers. Return Insurance provides 30 days for you to try a mask and return it for any reason for a refund of the price of the mask. If you are trying a mask for the first time, Return Insurance might be right for you.

Like our machine comparison chart, we have created a CPAP Mask Comparison Guide to help you compare different masks. This guide stacks up every mask we sell, feature by feature. If you don't know the meaning of a feature, click the question mark for a definition. The links below will take you to the most popular masks, or to the different types of masks we sell.

Masks should be washed daily with warm water using a very gentle soap or baby shampoo, and left to air dry. Never use antibacterial soap as it will break down the silicone of the mask cushion. Avoid soaps that include lotion which can coat the mask and cause it to lose its seal. A safe cleaner is the Control III Disinfectant CPAP Cleaning Solution. Remember, going to bed with a clean face will improve your seal and protect the lifespan of your mask.
The best time to clean your mask is in the morning after use. This removes the oils left behind from your skin which can reduce the lifespan of your mask. We recommend using mask wipes to make daily morning cleaning easy. The mask wipes are made from materials that will not break down your mask.

Medicare allows for mask cushion replacement every three (3) months, and a complete mask system replacement every six (6) months. CPAP manufacturers and vendors suggest these replacement schedules as well.

In our experience, most mask cushions begin to deteriorate after about six months of use. The cushion eventually becomes too soft to hold a seal. The headgear straps lose elasticity and must be tightened more and more to get the same quality seal.

We strongly suggest replacing cushions and pillows as soon as they start to soften. Air leaks may reduce the effectiveness of CPAP therapy and headgear that is too tight may cause facial sores at pressure points. In most cases, replacement headgear is available if it is stretched out or the Velcro worn out.

To see what parts of your mask are replaceable refer to our Replacement Part Finder. Just search for your mask to see all of the replaceable parts.

For many masks there are parts that are replaceable such as the mask cushion, headgear, headgear clips and other parts. To find parts which are compatible with your mask, or to find which parts of your mask are replaceable, you can:

Sores inside the nose may be caused by nasal pillow or nasal prong devices that are too big or the wrong shape for your nose.

If you use nasal pillows, try the smallest size available that seals around your nares. Your nose might also be sensitive to the presence of the nasal pillows, and it might take time for your nose to "toughen up" and adjust to the nasal pillows. Try switching back and forth between the nasal pillow mask and a nasal mask. You might also try nose lubricants to reduce the irritation.

Nasal prongs must be inserted into the nostrils and seal tightly, so they may cause irritation or sores. It may be just a matter of your nose "toughening up" over time, so try switching back and forth between the nasal prong device and a nasal mask. If the sores do not heal, we suggest you discontinue using the nasal prongs.

Sores inside the nose may also be caused by the CPAP air drying out the mucous membrane. Adding moisture with a heated humidifier will help alleviate the problem.

Air leaks are caused by masks that are too big, too old, or just the wrong style.

Air leaking into the eyes is usually an indication that the mask is too big (long or wide) as are leaks at the base of the nose. Leaks may also occur under the nose due to facial hair.

As the silicone in the mask cushion ages, it deteriorates and becomes too soft to hold a seal. For many masks, the cushion may be removed and replaced to extend the life of the mask. View our Replacement Part Finder to see if a replacement cushion is available for your mask.

When a cushion has softened to the point where it will no longer hold a seal, you may be able to tighten it enough to stop the leaking when you go to sleep, but during the night the seal will loosen and leak.

Mask leaks may also be caused by the pillow pushing against the mask and changing the position and seal of the mask. There are special CPAP pillows which are are designed to minimize the contact of the CPAP mask with the pillow, even when you are sleeping on your side.

The primary reason that nasal passages sometimes dry out from CPAP use is lack of adequate humidification.

CPAP air is an irritant - to one degree or another - to everyone. The irritation may cause the nasal passages to dry out and bleed, or the mucous membranes may try to protect the nasal passages by producing excess mucous and so congestion results. And the irritation can be cumulative; the problem may develop over time. Furthermore, dry, cracked or bleeding nasal passages are a breeding ground for infection.

Using a heated humidifier to add moisture to the CPAP air may reduce or eliminate the irritation. An unheated, passover humidifier may not offer enough additional moisture. If you are already using a heated humidifier, try turning it up to a higher setting. If that produces condensation in the six foot hose, you should try an insulating cover for the hose. You can also try using a nose lubricant to reduce the dryness.

Most red marks on the face are caused by over tightening the CPAP mask. CPAP masks should only be tightened down enough to create a seal. To avoid over tightening your mask, you should work clockwise around the mask, making small adjustments to the headgear, until the mask is securely in place but not overly tight. You should avoid pulling too much on one side of the mask than then other.

By cleaning your mask cushion, nasal pillows, and nasal prongs on a daily basis, you ensure a better seal each time you put on your mask. If you know you have a mask that fits, and are cleaning it daily, and still have red marks, consider using mask straps pads which are soft covering for the headgear straps.

People remove their mask during sleep because they are not getting enough air.

The CPAP pressure may be reduced if your mask is leaking. Your mask may be too big or too old. We would suggest you resize your mask to be sure you have the best size. If your mask fits you but is six to nine months old, it should be replaced. As the silicone in the mask cushion ages, it deteriorates and becomes too soft to hold a seal. For many masks, you can get a replacement cushion. See our Replacement Part Finder to see if your mask has a replaceable cushion.

If the CPAP air is being delivered effectively and without leaks, it may be that the pressure is set too low. Pressure settings may require change due to weight gain or loss and aging. You should speak to your doctor if you think your pressure may need to be adjusted.

The answer to this cycle is humidification. If the mouth continues to open during sleep, a chinstrap may be needed to hold the jaw up so that the mouth can close.
If mouth breathing continues, a full face mask, hybrid mask, or oral mask is suggested. See our recommended masks for Mouth Breathers.

Dry mouth is a sign that you are opening your mouth while you sleep. If you use a nasal mask, breathing through your mouth bypasses any humidification you may be using so increasing the heat will not be effective. Breathing through your mouth while using a nasal mask reduces the benefit of the CPAP therapy.

First be sure the mask is not leaking. If it is six to nine months old and leaking, try replacing it. If it is new and leaking, we can help you get a better size.

If your mask is new and NOT leaking, try a chinstrap to keep your jaw up and mouth from dropping open during sleep. If a chinstrap doesn't solve the problem, try masks recommended for mouth breathers.

If you use a full face mask and have a dry mouth, try adding a heated humidifier to add moisture.

Sores, redness and bumps around your nose can be caused by one of three main reasons: facial oils are building up under the mask material; the mask is overly tight; or the mask material is causing an allergic reaction.

A breakout can occur from the facial oils building up under the mask at night. You can help minimize this by washing your face before putting on the mask at night and by cleaning the facial oils off the mask every morning. If you are still experiencing a breakout, you might consider Nasal Pillow masks which have less material that comes in contact with the skin.

Sores at the bridge of the nose or below the nose are usually due to tightening the headgear straps too much. The pressure will create soreness, then a bruise, and may eventually create an open sore if left untreated. Your mask should seal when worn comfortably. If you have to over tighten your mask to get a good seal, consider switching to another mask type. To avoid over tightening your mask, you should work clockwise around the mask, making small adjustments to the headgear, until the headgear is securely in place but not overly tight. You should avoid pulling too much on one side of the mask than then other.

Most masks are made of silicone, which is an inert substance. But silicone is manufactured in chemicals to which some people are allergic. The chemicals normally degrade and disperse over time, but may cause a reaction when first used. The solution is to remove surface chemicals before using the mask. Washing the mask will reduce or eliminate the problem. This process can be accelerated by long soaks in warm soapy water. This method can be used with all types of masks, and should also be applied to mask replacement parts. While soaking the mask will help remove the surface chemicals, it my reduce the life of the silicone.

The primary reason why nasal passages sometimes dry out from CPAP use is lack of adequate humidification.

CPAP air is an irritant - to one degree or another - to everyone. The irritation may cause the nasal passages to dry out and bleed, or the mucous membranes may try to protect the nasal passages by producing excess mucous and so congestion results. And the irritation can be cumulative; the problem may develop over time. Furthermore, dry, cracked or bleeding nasal passages are a breeding ground for infection.

Add a heated humidifier to add moisture to the CPAP air and reduce or eliminate the irritation. A passover humidifier may not offer enough moisture. If you are already using a heated humidifier, try turning it up to a higher setting. If that produces condensation in the six foot hose, you should try an insulating cover for the hose. You can also try using a nose lubricant to reduce the dryness.

You can also try using a sinus rinse before going to bed and again once you wake in the morning to help clear your sinuses.

A lot of new CPAP users report having an increase in sinus congestion after starting CPAP therapy. When treating your Obstructive Sleep Apnea, sinus congestion presents a roadblock to healthy breathing. CPAP air is an irritant - to one degree or another - to everyone. The irritation may cause the nasal passages to dry out and bleed, or the mucous membranes may try to protect the nasal passages by producing excess mucous and so congestion results.

The best option is to add a heated humidifier to add moisture to the CPAP air and reduce or eliminate the irritation. If you are already using a heated humidifier, try turning it up to a higher setting. If that produces condensation in the six foot hose, you should try an insulating cover for the hose. Other options are to:

Wait and See

Visit your the ear/nose/throat doctor, and let them know you are on CPAP therapy.

Try using a sinus rinse before going to bed and again once you wake in the morning to help clear your sinuses.

As a general rule, persons with Obstructive Sleep Apnea should avoid using sedating medicines. Sedating medicines relax the muscles of the air passage even more and can effect your apneas. You should consult your doctor before using these types of medicines.

Bloating is a sign that you are swallowing the CPAP air. There is no real medical solution, but we have found that sleeping position may be a factor. Try sleeping as flat as possible first, even without a pillow. If that position doesn't help, try sleeping on your side or elevated, whichever one you don't sleep in now.

If changing your position doesn't resolve the problem, talk to your doctor about the possibility of lowering your pressure a bit. It may let a few apneas through, but the trade-off might be worth it.

Yes, all CPAP masks and CPAP humidifier chambers either contain BPA or their manufacturer has not released a statement calling their products BPA free. Here is a statement released by Respironics:

Government of Canada Takes Action on Another Chemical of Concern: Bisphenol A

April 25th 2008

To Whom It May Concern

This document represents Respironics' position regarding the use of Bisphenol A in Respironics Sleep and Home Respiratory Devices. On April 18, 2008, the Government of Canada, banned the use of Bisphenol A (BPA) in polycarbonate baby bottles, claiming that the exposure to BPA on newborns and infants up to 18 months of age, could potentially present a health risk to this patient group when the polycarbonate baby bottles are exposed to high temperatures.

At this time, we are able to provide the following information to our customer: NONE of our Sleep and Home Respiratory products which are either breathable or skin contacting are intended for use with newborns or infants under 18 months of age. Therefore, Respironics is in compliance with Health Canada's position for exposure for the identified at risk patient population.

Although Health Canada's restriction for BPA does not include products used for ages above 18 months at this time, Respironics is evaluating its product portfolio and will take the appropriate actions to determine and mitigate any potential risk from use of its products or potential exposure to BPA. It should be noted that NOT all polycarbonate resins contain BPA. In response to the direction provided by Health Canada's device licensing division, Respironics will be evaluating all of our Class II and III medical devices to determine if the resins used in the manufacturer of its products contain BPA.

Further, none of our products or accessories using polycarbonate are labeled for exposure.

In closing it is Respironics position that our products do not pots any increased risk of exposure to BPA for our users and thus our products remain safe for use.

If you have any further question regarding this topic, please feel free to contact me at zita.yurko@respironics.com or at 724-387-4120.